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JOURNALS AND REVIEWS.

JO’1l’l’J1al of Experimental Medicine (New York and London :D. Appleton and Co.).-In No. 3 of the third volumethe first two papers deal with a case of Teratoma of theAbdominal Cavity recorded by Dr. Douglas W. Montgomery,from a study of which Dr. Montgomery and Dr. Lewellys F.Barker are of the opinion that they have a definite fact insupport of Cohnheim’s vestigial doctrine regarding the originof tumours in general. Dr. C. A. Herter contributes a

Study of Fat with a special Reference to the Productionof Serous Atrophy of Fat, from which he concludesthat prolonged fat starvation leads to the entire dis-

appearance of fat from the adipose tissues and that thisform of fat atrophy is essentially of the same type asthat found in the epicardial and perirenal fat in the humansubject as the result of any wasting disease. He also notesthat the lecithins of the brain and the fat of the liver arenot materially reduced by fat starvation ; that carbohydratefood or carbohydrate and proteid constituents of milkin considerable quantities may largely take the place of fattyfood in preventing serous fat atrophy of the subcutaneousfat (fat starvation), but this may cause a very imperfectabsorption of the salts of phosphoric acid from the

intestine. Dr. Thomas R. Brown, in a paper on Studies onTrichinosis with Special Reference to the Increase of the

Eosinophilic Cells in the Blood and Muscle, the Origin of theseCells and their Diagnostic Importance, maintains that there isa marked increase of these cells under the above-mentioned

conditions ; that the muscle fibres are split longitudinallyand undergo a characteristic degeneration; and that nearthese degenerated muscle masses he has seen a few of thesecells accumulated. He holds that the increase in the

eosinophiles may in certain instances take place in the

muscles by direct transition from the neutrophiles, as here hefinds various transitional stages between the two forms. IDr. Mark Wyman Richardson draws attention to the fact that Ifthe typhoid bacillus in the urine of typhoid fever patientsoccurs in a proportion of about 25 per cent. in 38 cases exa-mined in large numbers and in practically pure culture; thatthey occur more frequently in the later stages of the diseaseand especially where albuminuria is present. The importanceof this observation from the point of view of preventivemedicine can scarcely be over-estimated. The other papersin this number are one on the Branched Form of the BacillusTuberculosis in Sputum, by Dr. Charles F. Craig; anotheron the Effects upon the Blood of the Tufnell Method and theCalcium Salts in the Treatment of Aortic Aneurysm, byDr. Alonzo Englebert Taylor; and Experiments on the

Application of the Roentgen Rays to the Study of

Anatomy, by Ernest Amory Codman, M.D. In numbers

4 and 5, Volume III., of the same journal Dr. W. T.Councilman, in an article on Acute Interstitial Nephritis,draws attention to the important part that Unna’s

plasma cells play in forming the cellular foci which

occur in this condition during the course of diphtheria,scarlet fever, and similar conditions. These are not due

necessarily to the local action of the bacteria, though inthree cases plasma cells were found in the interstitial tissuein definite diseases of the kidney ; but as he points out inthese cases they were not found in connexion with the

lesions produced directly by the bacteria but in the peri-phery of the purulent foci. Other papers comprise a Case ofMycetoma (Madura Foot), by James H. Wright ; Pseudo-Tuberculosis Hominis Streptothricha, by Simon Flexner,M.D.; and a Comparative Study of Bovine Tubercle Bacilliand of Human Bacilli from Sputum, by Dr. Theobald Smith.This last paper is in many ways extremely suggestive; butthe author does not take up any definite thesis, thoughhe insists, and very rightly so, that from his experi-ments it is desirable to study the tubercle bacillus in its

various aspects in order to determine the relation of the-

sputum bacillus to the bovine bacillus as regards virulence,and that it is especially necessary to do so in connexion withthe intestinal tuberculosis met with in children. It will be-

gathered, however, that Dr. Smith holds to the opinion thatthere is a marked difference in virulence between the tubercle’

bacilli of cattle and those derived from sputum of the humarasubject. Dr. William Hallock Park and Dr. James P. Atkin--son contribute a paper on the Relation of the Toxicity of’

Diphtheria Toxin to its Neutralising Value upon Antitoxin at’.Different Stages in the Growth of Culture. Whilst agreeing’generally with Ehrlich as to the composition of diphtheria,.toxin and as to the varying neutralising value of a minimal,fatal dose of toxin, they hold that epitoxoids are not.

necessarily formed, as suggested in Ehrlich’s originalpaper, and that it is possible to obtain a toxin of a knowc,and suitable neutralising value by using the same bacillus-not necessarily the same broth-but growing the culture at,the same temperature for a definite period of time. They.think that this will give a better standard than, or at anyrate an equally good standard as, Ehrlich’s standard anti-toxin. Dr. T. M. Cheeseman and Dr. S. J. Meltzer, in amost interesting paper on the Inoculation of Bacteria intothe Spleen, maintain that cultures of bacillus coli communis;,bacillus typhosus and staphylococcus pyogenes aureus,.when injected into the tissue of the normal spleen, soondisappear from that organ and, indeed, from the normalbody generally. When, however, the vessels have been

previously tied these micro-organisms multiply rapidly in the-spleen, although those which escape into the circulation aresoon destroyed. It is only when lesions have been made inthe spleen or any other organ or subcutaneous tissue that7these organisms can multiply, and those escaping, as a.

rule, are rapidly destroyed as they make their way into theblood.

Birnincy7acmlledical Revie7v.-In a paper in the Novembernumber on the Treatment of Chronic Disease Dr.’Alfred Carter-recommends (1) the formation of clinical laboratories where-chemical and physiological investigations of cases can be con-ducted by trained assistants at a minimum cost; and (2) the:establishment of fully equipped sanatoria available for the’treatment of chronic disease. Under the heading of "A.Modern Social Problem " Mr. Henry May, late medicalofficer of health for Aston Manor, calls attention to the

reduction in the birth-rate and marriage-rate and to themodern undercurrent towards restraint of fertility."

Jo2crnal of Pathology and Bacte’l’iology.-In the third

number of Volume V., October, 1898, the following papersappear :-Bacillus Coli Capsulatus : a Study in Virulence,by Dr. Louis Jenner; A New Micrococcus, with a Note-

on the Bacteriology of Lymphadenoma, by Dr. John,Hill Abram ; Mouse Favus, by Dr. John Hill Abram ; On a-Method of Estimating the Production of Acid by Bacteria..in Nutritive Media, by Dr. William Hanna ; The Durabilityof Passive Diphtheria Immunity, by Mr. Wm. Bullock; A.Contribution to the Study of Passive Immunity, byDr. J. W. W. Stephens and Dr. W. Myers; The-

Condition of the Salivary Glands and Pancreas in,

Chronic Tuberculosis, by Dr. Vincent Dormer Harris; ;.Experiments to Determine whether Sewer Air will raise,the Toxicity of Lowly Virulent Diphtheria Bacilli, byMr. Samuel G. Shattock; Molluscum Contagiosum in Two.Mated Bunting Sparrows, by Mr. Samuel G. Shattock;. z.

Supernumerary Dorsal Fin in a Trout, by Mr. C. G. Selig-mann ; The Changes Occurring in the Blood of Dogs after-Removal of the Thyroid, by Dr. A. G. Levy ; Note on the:Presence of Iron in the Liver and Spleen in Two Cases ofMalaria, by Dr. J. Everett Dutton; On the Effect of InjectingDilute Sulphuric Acid into the Common Bile Duct, by Mr.Wakelin Barratt; The Effect of Marchi’s Fluid on Nervous6

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Tissue that has Undergone Post-mortem Change, by Dr.Frederick E. Batten ; The Bone Marrow of Cancer Patients:a Reply to Dr. Francis Villy’s First Paper, by Dr. HerbertSnow ; A Case of Deciduoma Malignum, by Dr. J. K. Kellyand Dr. John H. Teacher; Laboratory Notes: A SimpleMethod of Restoring the "Spiking" of the Bacillus Anthracisin Gelatine Stab Cultures and A Modification of Pitfield’sMethod for Staining Flagella, by Mr. Richard Muir. Thisnumber contains much matter of interest alike to the

bacteriologist and pathologist and to the physician andsurgeon.

Revista Medica de S. Paulo.-We have received severalnumbers of this Brazilian monthly medical journal, whichmade its first appearance in the early months of the presentyear. The opening article of the March number is a

Portuguese translation of an address delivered in Italian

by Professor Sanarelli on his first experiments on the

employment of serum as a remedy and prophylactic againstyellow fever. The June number has an illustrated descrip-tion by Dr. Francisco Fajardo of a hasmatozoon found inberi-beri. The September number contains papers on YellowFever by Dr. Vital Brazil, Dr. Victor Godinho, and Dr.Benigno Ribeiro. Dr. Adolpho Lutz has an interesting seriesof articles on Intestinal Worms and the Diseases producedby Flies in San Paulo. The editors of the journal, Dr. VictorGodinho and Dr. Arthur Mendonca, have made an excellentbeginning.Mercy and Truth.-One of the articles in the November

number is Dr. Carr’s account of a week’s hard riding inPersia, being an urgent journey from Julfa to Kirman, inorder to attend the late Rev. H. Carless, who had beentaken seriously ill at the latter place.

THE ADMINISTRATIVE CONTROL OFTUBERCULOSIS.

THE QUESTION OF THE COMPULSORY NOTIFICATION OFPHTHISIS.

THE third and last Harben Lecture on AdministrativeMeasures for the Control of Tuberculosis was delivered bySir Richard Thorne, K.C.B., F.R.S., at the Examination

Hall of the Conjoint Board, Victoria Embankment, on

Nov. 16th, the subject discussed being the question of thecompulsory notification of phthisis.The lecturer pointed out that a certain number of

sanitary authorities had applied to the Local Govern- ’,ment Board for their statutory approval to add phthisisto the list of the infectious diseases which are now

included in the Infectious Disease (Notification) Act, 1889, butthat this approval had never yet been given. He agreedwith the action of the central authority, and he pointed outthat there was no such similarity between phthisis and thediseases now notifiable-namely, small-pox, scarlet fever,diphtheria, &c.-as would, in his opinion, justify compliancewith the demand made. The Notification Act was passed inorder to enable authorities to control the movements of per-sons who for a few weeks only of their lives were in a statewhich constituted a danger to the public health, such personsbeing, by reason of a temporary and acute illness unfit tofollow their usual avocations or to mingle with others.In the case of phthisis, however, any corresponding sanitarycontrol would often have to be exercised for a series of years,during which time the phthisical persons were not only quitecapable of continuing in their employment, but it was oftenabsolutely essential that they should be able to maintainthemselves and at times a family as well. The Act wasnever passed to enable such persons to be subjected torestrictions in the manner intended to apply to the acuteinfectious fevers. He referred in some detail to the notifica-tion of phthisis in New York City because it was often heldout as an example to be followed; but he showed that the NewYork provision has hitherto been most partial in its applica-tion, that its operations were in the main limited to personsliving in tenement- and lodging-houses, and that apart from

this no sanitary control was exercised except with the actual ortacit consent of the medical practitioner in attendance onthe patient. Even the statistical results which were quotedin favour of the New York practice showed that the diminu-tion in the phthisis death-rate was in full operation foryears before the notification system was established. Thiswas doubtless to a large extent brought about by the sameadministrative measures which in this country had already ledto a saving of no less than 60 lives out of every 100 which atmany age-periods were formerly sacrificed to this disease.Instances were then given to show what would certainlyfollow if the stringency of our laws as to infectious diseasewere made applicable to this disease. The system of inspec-tion by sanitary officials would lead to publicity and to lossof employment, with the consequent deprivation of food andcomforts which are essential to the cure of the disease in itsincipient stages, while it would hinder people from seekingmedical advice at a time when this was most useful,and thus would defeat the main object in view. Itwas next pointed out that the same proposal had come

before the Academy of Medicine in Paris and that on

a report from a committee of that body the system ofcompulsory notification had been rejected on the groundthat it was likely to do more harm than good. The conclusionat which the lecturer arrived did not, however, justifyinaction as regards a disease which still caused some 40,000deaths every year in England and Wales and which is largelyspread by means of highly infective sputa which when driedwere carried about as dust. The duty of giving to indi-viduals advice as to dealing with these sputa which waslikely to be followed devolved, in his opinion, on the medicalpractitioners whose counsel and help were voluntarilysought by the phthisical patients; and the lecturer appealedto all physicians, whether in hospital practice or in privatepractice, to give this advice in some such simple form as is tobe found in the leaflets now distributed to patients visitingcertain of the chest hospitals of the metropolis. Any actionby way of notification should, for the present at least, beunder a voluntary and not a compulsory system, and suchaction might well be supplemented by the construction outof public funds of sanatoria for the temporary isolationof persons suffering from this infectious disease, who duringtheir sojourn in these establishments would acquire habitsof dealing with infectious materials which would tend toprevent that spread of infection now so largely due to thewant of simple and inexpensive precautions. In con-

clusion, it was pointed out that the success attained underour English system of public health is largely due to thefact that the leaders of that system have been contentto lead, and have avoided pressing so far ahead of publicopinion as to alienate that support on which success is mostdependent.

EAST SUBURBAN MEDICAL PROTECTION ANDMEDICO-ETHICAL SOCIETY, LIMITED.-This society is

progressing and since the last general meeting in Octoberreported in THE LANCET it has elected about 30 newmembers. Two council meetings have been held andnumerous matters of interest discussed. Action has beentaken in 1 gross case of unprofessional conduct and thematter dealt with by the practitioners’ licensing body uponevidence laid before it by the society. The Plaistow

Maternity Home has sent a favourable reply to the requestsof the society for the abolition of midwifery fees by thehome, and the representation of the local medical

practitioners upon the committee of the home is stillunder discussion. The debt collecting department hasbeen still further made use of by the members andwith success. Sub-committees have been appointed toconsider the working of medical aid societies, to arrangefor the holding of clinical and social meetings, and to dealwith other subjects. Active local branches have been formedat Manor Park, Leyton, Canning Town, and Plaistow, andother branches are in course of formation in other dis-tricts. The local branches have also appointed sub-com-mittees to collect evidence and otherwise consider the ques-tion of the abuses in local medical charities. The nextexecutive council meeting is to be held on Thursday, Dec. 8th,when the council will proceed to consider inter alia the nomi-nations of the officers of the society for election at the generalmeeting in January. A nomination paper and notice willshortly be sent to all members and they are reminded toreturn them duly filled in at least two days before the meetingor they will be disqualified.